M. D. Anderson Raises Importance of Patient-Physician Communication;

The University of Texas M. D. Anderson Cancer Center is reinforcing the message of effective patient-physician communications to the world's leading organization of cancer care specialists.

Today (Saturday, May 18) at the 38th annual meeting of the American Society of Clinical Oncology (ASCO), Dr. Walter Baile, chief of psychiatry at M. D. Anderson and a leader in the study and teaching of patient-physician communication and relationships, and his colleagues discussed techniques for effective dialogue between doctor and patient, and demonstrated such skills with a new video featuring actors William Hurt ("The Doctor") and Megan Cole ("Wit"). Also at the conference, Cole used theatre to teach health care professionals valuable communication techniques such as empathetic listening.

"In the video, we address the patient-care challenges facing oncologists that affect a physician's thoughts, feelings and behavior towards the patient. Such challenges include the high fatality rate of cancer, dealing with unrealistic patient expectations, the complexities of explaining complicated treatments and the perils of developing friendships with patients who the die," says Dr. Baile.

The ASCO presentation featured a seven-minute excerpt from "Being an Oncologist," Dr. Baile's latest educational endeavor -- a collaborative effort with Dr. Robert Buckman and M. D. Anderson's Offices of Public Education and Faculty Development -- that invites doctors to reflect on the personal aspects of cancer care.

In "Being an Oncologist," Hurt and Cole assume the personas of various doctors. Using dialogue gathered by physician focus groups, the two sit before the camera as though they are two doctors having coffee at the end of a long day and share their feelings about the stress of caring for patients with life-threatening illness. They talk about the time pressures; the challenge of breaking bad news; the need to keep hope alive; the balance of sympathy and empathy and keeping personal boundaries, as well as dealing with both the patient's and their own emotional reactions.

"Being an Oncologist" and a corresponding workbook are funded by the M. D. Anderson's University Cancer Foundation and are being distributed at no charge to 7,000 ASCO participants.

"Through distributing the video, we hope to encourage discussion on topics not usually brought up in physician training but that nonetheless represent barriers in patient care," says Dr. Baile. "Oncologists naturally focus on technical solutions to medical problems. Patients with serious illness, however, can greatly benefit from having a physician who is able to listen, be empathetic and give bad news in a supportive way to the patient. And yet many medical students never hear a lecture on skills such as how to communicate bad news to patients."

As the star of "Wit," the Pulitzer Prize-winning play chronicling the emotional journey of a strong-willed professor of literature who is diagnosed with advanced ovarian cancer, Megan Cole addresses many of the same emotions, decisions, questions and issues facing cancer patients throughout their cancer journey. Cole's performance on-stage at ASCO highlights the empathy and rapport developed between patients and their physicians.

"As an actor, Megan Cole's relationship to the audience parallels the relationship to that of a doctor with a patient," says Dr. Baile. "She has developed an educational program utilizing theatre techniques to instruct physicians on how to have empathetic responses to patient concerns as well as to listen without being judgmental."

Hurt also has experience addressing the relationship between patients and physicians. In "The Doctor," Hurt plays an extraordinarily skilled surgeon with less-than-desirable people skills. It's only after the doctor is diagnosed with cancer that Hurt's character develops a true understanding for the patient side of cancer care.

The relationship between physician and patient is the cornerstone of oncology care, explains Dr. Baile, having direct affect on patient decision-making, informed consent and compliance. Such inter-personal issues have occupied Dr. Baile throughout his career. His special interest has been training oncologists in physician-patient communication and studying issues of death and dying. Baile is a co-founder of organization known as Advancing Communication in Oncology through Research and Education (ACORE), a group designed to develop curriculum for patient-physician communications in medical schools.

According to Dr. Baile, oncologists conduct up to 25,000 interviews with patients and family members during the course of a career. Moreover, research conducted by Dr. Baile and his colleagues have shown that patients today want more information, demanding that physicians become greater communicators.

M. D. Anderson has taken the lead in this area and is one of only a few cancer centers in the country that has provided regular communications training for faculty and trainees.